Dear Mauricio.

The most important in the treatment of TMJ disorders is the correct diagnosis. Its origin is almost always multifactorial, but it is very associated with dental occlusion problems. Occlusal interferences, absence of tooth, bruxism, absence of incisive or canine guides among others, are strong predisposing factors. When they are associated with stress problems, they usually express the symptoms of dysfunction that range from joint sounds, joint pain or pain in the masticatory musculature, difficulty in opening the mouth and even mandibular dislocation. Depending on the time of action and the structures affected, these symptoms may or may not be reversible with the correct treatment. You must be valued by a specialist. The dentists are usually the most qualified to provide the care you need. The treatment should be aimed at eliminating the causes that induce the dysfunction, that is, if your problem is occlusal interferences, they should be treated by an orthodontist, if it is by absent teeth, they should be restored whit prosthetic elements. Your dentist will know how to guide you used in the treatment. It is common to use myo-relaxing splints that are tailored to the patient's needs to avoid the most acute symptoms. Never use any commercial device. Once the patient is relieved, the cause will be eliminated with the appropriate specialist. Another type of treatment, as you say, is paleative and only provide temporary relief at best. I hope you find this information useful.

I'm not advice you to do surgery to TMJ .

The best treatment is to wear a bite plate for 3 months at night.

If there is clicking or lock in TMJ hyaluronic acid intra articular injection is indicated which is safe and effective and without side effects.

Best regard

yes botox works

The injections goes into the masseter muscle," . "The masseter muscle is one of the muscles activated during chewing. It's located at the angle of the jaw. I usually start with 50 units of botox (25 units on each side). It takes five minutes.

the other muscle i inject in is the lateral pterygoid and this muscle is really the cause of any of the problems of TMJ pain

"Botox can be used both functionally (to weaken the masseter muscle and the lateral pterygoid muscle , which cuase tmj problems like bruxism(grinding) , and improve the pain of TMD ), '

Dr.K.A.Galil.Professor of Medicine and dentistry

DDS.,D.Oral & Maxillofacial Surgery ,PH.D,FAGD.,FADI.,Cert.Periodontist(Royal College ) Departments of Periodontics,Orthodontics and Clinical Anatomy Schulich School Of Medicine and Dentistry. University of Western Ontario London,Ontario. www.drgalil.ca

É uma opção

prof. k.a Galil how do you inject the lateral pterygoid muscle? do you use intraoral ultrasonic guided injection?

thank you

Mostly itealogy tmj problem is multi factorial and one of the factor TMJ disorder is clenching ,bruxisum and bad habit like nail bitting which cause tmj pain. So in this case muscles of masticatory dynamically are involved. To treat such a condition patients need rest to tmj. So BOTOX temporarily reduced the tonisity and hyperactivity of the masticatory muscles for few months so this is the option of treatment for TMJDS.

Dr.Ali Hasan sorry i didn't see your question on January 31 where you say

"prof. k.a Galil how do you inject the lateral pterygoid muscle? do you use intraoral ultrasonic guided injection?"

My apologies for being late ,i did not see the question and as we say here better late than never!!!

Answer:

we inject directly at the lateral pterygoid muscle .we tried to use intra oral ultra sound ( you said ultrasonic but i presume you mean ultra sound ) .We found that the image is distorted with ultra sound because of the vertical ramus . we spent hours on ultra sound detection of the lateral pterygoid muscle and was frustrating to find it .you can see a very small part of it the upper head which as you know arises from the upper surface of head: infra-temporal surface of the greater wing of the sphenoid bone. Inferior head: lateral pterygoid plate in that area can be seen but distorted by Ultra sound .however since clinically it is very easy to determine we inject directly into it very carefully and we watch for the maxillary artery which as you now sits one third of the time on the surface of the lateral pterygoid ,we certainly recommend aspiration and careful injection.i have enclosed here some of our work on ultra sound.hope it helps

Dr.K.A.Galil.Professor of Medicine and dentistry

DDS.,D.Oral & Maxillofacial Surgery ,PH.D,FAGD.,FADI.,Cert.Periodontist(Royal College ) Departments of Periodontics,Orthodontics and Clinical Anatomy Schulich School Of Medicine and Dentistry. University of Western Ontario London,Ontario. www.drgalil.ca.

Botox does led to significant effects when injected into masseter. I have attached an article below that would help you to obtain more information.

Dutra EH, Yadav S. The effects on the mandibular condyle of Botox injection into the masseter are not transient. Am J Orthod Dentofacial Orthop. 2019;156(2):193-202. doi:10.1016/j.ajodo.2018.08.023

Article The effects on the mandibular condyle of Botox injection int...